Individual
AMANDA M HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 45417-3424
(937) 734-8333
Mailing address
601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 45417-3424
(937) 734-8333
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.0900620
OH
104100000X
Social Worker
S0900620
OH
1041C0700X
Clinical Social Worker
Primary
I2002357
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QM0801X
GROUP NPI
—
Enumeration date
04/11/2018
Last updated
09/30/2020
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